Yoshimura Yoshitaka, Yokoyama Masamoto
Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital.
Seishin Shinkeigaku Zasshi. 2011;113(2):159-65.
Working in a general hospital psychiatry department, the authors treat patients with psychiatric emergencies who also have physical complications. Three primary treatment paradigms exist. The first is the medical management of patients with psychiatric emergencies who also have physical illnesses. Physical complications may occur due to external injury, internal secretions, metabolic disease, and treatment for psychiatric emergencies. In such cases, patients require not only psychiatric treatment but also medical treatment for their physical symptoms or problems. The second pattern is the management of patients brought to the emergency department after a suicide attempt. In this case, the cause of the physical complications is action derived from suicidal ideation, and somatic therapy is given priority. The third pattern is the often difficult management of physical illness in patients who suffer from chronic psychiatric illness. In a general hospital with no department of psychiatry, psychiatric patients with physical emergencies are often unable to obtain appropriate diagnosis and treatment. There is a greater need for general hospitals able to manage psychiatric emergencies and their physical complications during medical treatment.
作者在一家综合医院的精神科工作，治疗同时患有躯体并发症的精神科急诊患者。存在三种主要的治疗模式。第一种是对同时患有躯体疾病的精神科急诊患者进行医疗管理。躯体并发症可能由于外伤、内分泌、代谢疾病以及精神科急诊的治疗而发生。在这种情况下，患者不仅需要精神科治疗，还需要针对其躯体症状或问题进行医疗治疗。第二种模式是对自杀未遂后被送往急诊科的患者进行管理。在这种情况下，躯体并发症的原因是源于自杀意念的行为，并且躯体治疗被优先考虑。第三种模式是对患有慢性精神疾病的患者的躯体疾病进行往往较为困难的管理。在没有精神科的综合医院，患有躯体急症的精神科患者常常无法获得恰当的诊断和治疗。更需要能够在医疗过程中处理精神科急诊及其躯体并发症的综合医院。
